Individual provider Active NPI

Faith Ann Peats

  • Registered Dietitian
  • Daytona Beach, FL
National Provider Identifier
1932809183
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND4992 Issued in FL
Practice address
311 N Clyde Morris Blvd Ste 510
Daytona Beach, FL 32114-2757
Phone
(386) 241-1020
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND4992 FL Primary

Addresses

Primary practice location

311 N Clyde Morris Blvd Ste 510
Daytona Beach, FL 32114-2757

Mailing address

PO Box 100286
Gainesville, FL 32610-2911
Phone (352) 265-0761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230428000070 FL Practitioner - Registered Dietitian Or Nutrition Professional 5294190195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ND4992FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Mar 10, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Mar 10, 2023 Accepting new patients

Locations

311 N Clyde Morris Blvd
Ste 510
Daytona Beach, FL 32114
Phone (386) 241-1020

3300 E Halifax Crossing Blvd
Deltona, FL 32725
Phone (386) 425-1800

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1932809183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100286",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326102911",
            "telephone_number": "352-265-0761",
            "fax_number": "352-265-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD STE 510",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142757",
            "telephone_number": "386-241-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEATS",
        "first_name": "FAITH",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND4992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.